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University of Pennsylvania Smell Identification Test (UPSIT)
University of Pennsylvania Smell Identification Test (UPSIT)
| Availability |
Please visit this website for more information about the instrument:University of Pennsylvania Smell Identification Test
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| Classification |
Supplemental: Parkinson's Disease (PD)
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| Short Description of Instrument |
The Smell Identification Test (UPSIT) is a self-administered 40-item questionnaire. This test was developed over 25 years ago and has been used extensively in studies of olfactory dysfunction in diverse populations. It has been employed in numerous studies of PD patients. More recent modifications of this test have been developed, with fewer test items, but this test remains the standard test practical for evaluating olfaction in large groups of patients.
The test uses strips of paper impregnated with microencapsulated odors that are released upon scratching the strip with a pencil. The patient is given four choices from which to choose the correct odor. Forty different odors are presented in this test.
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| Scoring and Psychometric Properties |
Scoring: Forced choice of 4 responses to identify each smell. Anosmia: score 6-18; severe microsmia: score 19-25, moderate microsmia: 26-30 in women and 26-29 in men; mild microsmia: 31-34 in women and 30-33 in men; and normosmia: score > 34 in women and >33 in men.
Psychometric Properties: Strong test-retest reliability (r=0.9-0.95). Predictive validity in PD: cut-off score 21/40 can differentiate PD from control with 82% sensitivity and 88.2% specificity.
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| Rationale/Justification |
Strengths: Can detect even subtle alterations in olfaction, strong normative data, available in over 30 languages. Utility for PD diagnosis.
Weaknesses: Relatively expensive, only one-time use and limited shelf life (<6 months), potential limitation of cross-cultural applicability based on smells included (e.g., root beer).
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| References |
Key Reference:
Doty RL, Shaman P, Kimmelman CP, Dann MS. University of Pennsylvania Smell identification Test: a rapid quantitative olfactory function test for the clinic. Laryngoscope. 1984 Feb;94(2 Pt 1):176-8.
Additional References:
Bohnen NI, Gedela S, Herath P, Constantine GM, Moore RY. Selective hyposmia in Parkinson disease: association with hippocampal dopamine activity. Neurosci Lett. 2008 Dec 5;447(1):12-6.
Doty RL, Bromley SM, Stern MB. Olfactory testing as an aid in the diagnosis of Parkinson's disease: development of optimal discrimination criteria. Neurodegeneration. 1995 Mar;4(1):93-7.
Hawkes CH, Shephard BC, Daniel SE. Olfactory dysfunction in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1997 May;62(5):436-46.
Picillo M, Pellecchia MT, Erro R, Amboni M, Vitale C, Iavarone A, Moccia M, Allocca R, Orefice G, Barone P. The use of University of Pennsylvania Smell Identification Test in the diagnosis of Parkinson's disease in Italy. Neurol Sci. 2014 Mar;35(3):379-83.
Silveira-Moriyama L, Petrie A, Williams DR, Evans A, Katzenschlager R, Barbosa ER, Lees AJ. The use of a color coded probability scale to interpret smell tests in suspected parkinsonism. Mov Disord. 2009 Jun 15;24(8):1144-53.
Document last updated August 2022
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